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There is much lore about training room treatments for common overuse and traumatic musculoskeletal injuries. This review looks at the evidence behind many of the common transdermal treatments that are purported to reduce pain and inflammation and improve function. These include cryotherapy, laser treatments, electrical stimulation, ultrasound and phonophoresis, extracorporeal shock wave therapy, and iontophoresis. In addition, there are numerous over the counter sports creams and prescribed topical treatments that are routinely used. With the pressure to treat athletes safely and efficiently, sports practitioners must rely on well-proven evidence to build the most effective treatment plans.